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The Many Uses of Gui Zhi Tang


So first I’d like to describe how I see Gui Zhi Tang working and. Last time. I talked about the physiology of the shell hung lawn that I think is encoded into the Shang online.

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Hi, everyone. I’m so happy to be here. And I want to first thank the American Acupuncture Council for inviting me to do this series on Chinese herbal medicine. And last time I spoke about why I’m so sold on classical Chinese medicine in herbal medicine and defined that to mean working with the formulas from the Shang Han Lun and Jin Gui Yao Lue. And today I would like to express some of the principles that I talked about last time with focusing on the formula. And this is such a useful formula. It’s an inexpensive formula easy to take formula and the way we learned about it in our kind of typical TCM education is as a formula that will dispel wind. And we usually think of it as a formula to use for coming down with a cold or what we might call an external influence or an epi. And what I’d like to do is describe how useful it is beyond just a common cold, because quit your tongue is a formula that I use all the time in my practice for a wide variety of disorders. It’s also a very small formula, so it’s easily modifiable. And actually there are many formulas in the Shang Han Lun that are based on grade your tongue. So hopefully besides my main goal is to get people excited about studying classical formulas and working with them. But I also have a goal today of having the listener. Be able to go home and think oh, I can use this formula that you could use it next week for something you may not have thought to use it for. So first I’d like to describe how I see Gui Zhi Tang working and. Last time. I talked about the physiology of the shell hung lawn that I think is encoded into the Shang online. And that it’s really about being right with time. And there’s this kind of circular movement of heaven going around us while we’re here on the earth. And this same circular movement is going on in our bodies. And so great. Your tongue is, one of the first formulas. So I think the first formula would be mentioned in the Shang Han Lun in the Taiyang section. So understanding a little bit about Taiyang it’s this steaming up movement that goes from the middle warmer up to the surface of the body. And right after the tie young movement, it’s. Going up like the sun rising, it hits noon and now it starts going down. And the downward movement is the beginning of the Yangming Conformation. So when we’re, when our Taiyang is functioning it has this really nice steaming up. And if you think about what steam is, it’s young within yen. So when you have steam. You have this kind of fire that’s inside of water and that fire and water are so mixed that it’s actually steam. It’s this water that rises up because of the fire that’s inside of it. And that’s what Taiyang does is the, has a steam that goes up and how all the way to the surface of our body and that steam creates a nice ozone layer of warmth and protection. And when it functions well, we sweat. Normally we have a nice, comfortable body temperature. And what happens in a greater tongue pattern is you usually think of it as like an invasion of wind cold or an invasion of wind. I’d like to suggest thinking of it a little bit differently, that what happens in a Taiyang pattern is that movement of stinks. Going up to the surface of the body. It resolves too quickly. And so that fire and water separate before they’ve really reached all the way to. Surface of our body. So what do you get from this separation that we also would call a Ying Wei Disharmony, meaning the way that’s the warmth inside should be nice and inside the yang so that it brings it all the way up to the surface, but instead they separate. So you get sweating as the yang droplets lose their relationship with the. They come out as sweating and the young that’s lost its relationship with the yang. We get feverishness or flushing up. That’s what the yang way disharmony is in a way it’s like a premature ejaculation, that you want it to take as long as this, before it results, but instead it resolves too quickly and that becomes pathological. So when we give Gui Zhi Tang, we are supplementing the warmth and the fluid in the middle warmer, and we’re slowing down that process. So the steam rises and makes it all the way. To the surface of the body. And in fact, a Gui Zhi Tang pattern can actually treat premature ejaculation. Know we can explain premature ejaculation with the Gui Zhi Tang pattern because it’s a leaking pattern it’s coming out of relationship. So I said that the Gui Zhi Tang comes from the middle warmer, and you look at the ingredients of Gui Zhi Tang. We have gone. So Sheng Jiang and Gan Cao These supplement and warm the spleen we have Da Zao, which replenishes the nutrition in the spleen. So we’ve got this kind of fire inside of a nice juicy herbs. And that starts that steaming process in the spleen and stomach. Now Da Zao also enriches the blood. And so does Shao Yao. So what I’d like to show is that the Gui Zhi Tang formula, supplements the middle in a warm way, and it also supplements the blood and that the warmth in the middle and the good quality warm blood is what then is the foundation for the harmonized Ying and Wei to come all the way up and out to the surface. So really the Gui Zhi Tang is a supplementing formula, supplementing the spleen and also supplementing the blood. And from that replenishment, it then supports that consolidation of the exterior of the body. So by giving wager tone, we’re not just getting rid of a wind pathogen. Really it’s a healthy body, knows how to get rid of a wind path. Rather than just getting rid of the wind pathogen, we’re restoring this function of the body, the function of the body to have really nice harmonized Ying and Wei. So I want to talk first about this flushing up, that happens in a Gui Zhi Tang pattern and what that can look like. It can look like nausea and vomiting. If the flushing up affects the stomach. Then you can have nausea and retching. And that’s why Zhang Zhongjing put Gui Zhi Tang as the first formula in the pregnancy chapter of the Jin Gui Yao Lue for Pregnancy. In early pregnancy. So that’s one little gem I would like to give you is to really think about grade your tongue as a formula that can treat nausea and vomiting in early pregnancy. And it does it, that the reason that there’s the vomiting is because of the Ying Wei Disharmony and it, by putting that way back into the. It then it’s not flushing up anymore. It’s physiologically rising to the top of the body. So that’s one thing that we can treat with Gui Zhi Tang and it’s right in there in the Jin Gui Yao Lue. The other thing I want to mention is When the Ying and Wei separate from each other. It really means that the surface of our body, instead of getting that nice from ozone layer, that separation means that the surface of our body is too open in the Shang Han Lun. It says aversion to wind. And in my opinion the symptoms that are mentioned in the Shang Han Lun are both literal and symbolic. So the wind can mean that you have an aversion to just too much going on. In other words, you get overwhelmed really easily and you feel really hypersensitive. So imagine a patient who comes in and let’s say, it’s a woman and she’s, you can see that she has blood deficiency. You can see from her complexion, from our. Maybe from your abdominal diagnosis and, she’s got blood deficiency and at the same time, she tends to be a little bit cold and then premenstrually, she becomes very sensitive. We usually think of pre-menstrual syndrome as wanting to move the liver cheese. But many of our patients don’t actually fit that pattern and they don’t benefit from formulas like or something like that. There are many of our patients who come in and they experienced, they have premenstrually is they become hypersensitive. They feel very vulnerable. And if you question them one thing I like to ask is. Do you generally flush when you have emotions, like if you’d get embarrassed or if you have to speak in front of a crowd, do you flush easily? Do you sweat easily? In other words, that kind of person, their Ying and Wei tends to separate. And there, many of my patients have been really helped with Gui zhi Tang for PMS. Because of this. So what the Gui zhi Tang then does is it supplements the blood, it nourishes the spleen and it harmonizes the Ying and Wei. And it really creates a sort of ozone layer of protection on the exterior of the body. So people don’t feel so open and so vulnerable and they can handle more. Knowing that pre-menstrual time. Many women just feel like I can’t handle anything. Someone looks at me the wrong way and I just start crying. And Gui zhi Tang is really good for that. We can think of that also for peri-menopause or menopausal types of symptoms, which. The same kind of experience for people. So we can see that this range of grades, your tongue is really is really broad. There are also lots of modifications of Gui zhi Tang. Expand its usefulness in the clinic. A lot of these modifications are mentioned in the Shang Han Lun. So for example, a really favorite modification for me is a formula that’s called Gui Zhi Jia Shao Yao Tang, but the Shao Yao is doubled, so Zhang Zhongjing is telling us you can actually use more Shao Yao if you want to, and so it’s just great. You’re talking about you’re using more Shao Yao. So what happens to this formula that harmonizes the Ying and Wei? If you add. and there’s a couple of things that this formula is so useful for. Not so often I’m increasing the shadow. So what does the show do? And I, here, I’m talking about by shell. So the Shao Yao is a blood nourishing or, and one of the main indicators for me that I might want to double the Shao Yao is. Abdominal diagnosis. So with abdominal diagnosis, if I find that the rectus abdominis from under the ribs down to the navel are very tight for me, that’s almost always a by shout indication. And so in that case, I will have more by show. The other thing that often goes along with this abdominal finding is so common and it will go with a lot of these PMs kinds of women that I was talking about is neck and shoulder tension. We know that the bladder channel and the small intestine in general, they are on the trapezius and. And by show really nourishes the muscles, especially when we have Bai Shao, like we do in your, that becomes , which is for relaxing spastic muscles. And where are those muscles most likely to get really tense in the Gui Zhi Tang pattern. It’s going to be the tie on channels and the upper body, because there’s. Flushing up called? Nobose in Japanese this, when we talk about it in terms of abdominal diagnosis, so there’s flushing up, so it’s going to affect the upper body and then it’s affecting the Taiyang channels of the trapezius and neck. So very often people will say, yes, I, I carry so much tension in my neck and upper back. It’s always tight and painful for me. That’s an indicator for adding increased Bai Shao to Gui Zhi Tang. Very common. The other indicator for increasing the Bai Shao is related to the fact that Bai Shao is also bitter and it’s. And Bai Shao when it hit like bitter, because I’m putting my hand down this way because the bitter flavor descends in the body and by show is cool. So it’s very good for opening up the Yangming and treating constipation. So it treats constipation both because it’s very lightly purging. But also because it relaxes muscles, one muscles, relax. It’s not just that. It’s not like a muscle relaxer that makes all the muscles all Saudi ends up the way that by Bai Shao works to help the muscles. It helps muscles do what they’re supposed to do. So actually helps normal pair of spouses while stopping cramping. So another indication for adding by show is. Person that you’re seeing that feels so vulnerable and sweats easily and flushes. If they also tend to get constipation, you can increase the by show or abdominal pain. No. So in the Shang Han Lun, that’s what it’s for. ? is for abdominal pain. So that kind of cramping can cause constipation. It can also cause abdominal pain. So that’s a modification of Gui Zhi Tang, so easy and easy to remember because it just makes so much sense. Another modification that’s really listed just right after this Gui Zhi Jia Da Huang. Is if the constipation has gone on for more than three days, so it’s really blocked in there, so what happens when you’re constipated is that it sits in there and gets drier and drier, and then it just makes the constipation worse. So if you want to get. Flush just to break that cycle. In other words, it’s a short-term treatment, but you want that flush to be gentle. You want it to be body temperature, Gui Zhi Tang is body temperature. Then you have Gui zhi Tang plus the little bit of the Da huang And it’s a short term just to give the body an enema, except that it’s going in from the other direction, just to flush that out. And often that formula would be followed by Gui zhi Jia Shao Yao Tang. So I hope this is just a little 20 minute talk and there are lots of other modifications of greater time that are equally as elegant. And useful. My hope is that in this short little talk that at least I’ve given you a sense of how great your tongue can work for chronic illnesses and illnesses that have nothing to do with catching a cold just maybe inspired some people to get excited about classical formulas and studying them. Cause it’s such a beautiful way to work with our patients. And it’s beautiful in large part because it’s so effective. So I would like to also let people know that I’m the founder of the whitepinecircle.org. Which is an organization that promotes teaching such as these, and it’s a really, just a wonderful membership organization. So I’d just like to encourage you to check that out whitepinecircle.org. where there’s lots of teachings, just like this. If this excited you. I also teach a. Graduate mentorship program, where we just go through all of these formulas in a way that discusses them relative to these principles of classical formulas. You can find out about whitepineinstitute.org that’s listed right here. And then finally, I would like to, again, really thank the American acupuncture council. This is such a cool thing. They do. I’m offering short teachings just for us to get to know each other in all the wonderful things that are happening in the world of Chinese medicine. And I really appreciate their service to acupuncturists. And I’d also just like to mention that the next talk is going to be Matt Callison and Brian law. So I hope that you are able to attend that one as well. And I just really appreciate your attention to the things that I love so much. So thank you very much.